Fistulojejunostomy for the management of refractory pancreatic fistula

Nair, Rajalakshmi; Lowy, Andrew M.; McIntyre, Benjamin C.; Sussman, Jeffrey J.; Matthews, Jeffrey B.; Ahmad, Syed A.

doi:10.1016/j.surg.2007.07.019

Cited by 24 publications

(26 citation statements)

References 27 publications

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“…A fistulojejunostomy is performed as a ''fall back'' plan, as described previously by our institution. 26 There are limitations to this study. We have a relatively small sample size of surgery-first controls at our institution, which limits the power of comparative statistical analysis.…”

Section: Discussionmentioning

confidence: 90%

Routine use of U-tube drainage for necrotizing pancreatitis: A step toward less morbidity and resource utilization

Stahl

Moulton

Vũ

et al. 2015

Surgery

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Section: Discussionmentioning

confidence: 90%

Routine use of U-tube drainage for necrotizing pancreatitis: A step toward less morbidity and resource utilization

Stahl

Moulton

Vũ

et al. 2015

Surgery

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“…The surgical repair consists of precise identification of the fistula tract around a drainage tube (far from the pancreatic gland) and its anastomosis with a Roux-en-Y jejunal loop. This technique has been described by our group and other authors and has been shown to be associated with a very high success rate, despite the very limited indications [51,52].…”

Section: Surgical Treatmentmentioning

confidence: 85%

Diagnosis and management of postoperative pancreatic fistula

Malleo

Pulvirenti

Marchegiani

et al. 2014

Langenbecks Arch Surg

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The high incidence of POPF was accompanied by a shift from operative to non-operative management. However, the current management strategy is driven by the patient's condition and local expertise and is generally based on poor evidence. A randomized trial showed that enteral nutrition is superior to total parenteral nutrition, and pooled data of randomized trials failed to show any advantage of somatostatin analogs for accelerating fistula closure. The choice of percutaneous versus endoscopic drainage of peripancreatic collections remains arbitrary, and-when re-operation is needed-there are very few comparative data regarding local drainage with or without main pancreatic stenting as opposed to anastomotic revision or salvage re-anastomosis. The continuous development of specialist, high-volume units with appropriate resources and multidisciplinary experience in complication management might further improve the evidence and the outcomes.

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“…Pancreatic fistulae are not uncommon, and their development is due, in part, to proteolytic secretions [4], which can make them refractory to conservative management. In this case, a surgical approach to provide internal drainage was successful and proved an important and useful technique [5]. …”

Section: Discussionmentioning

confidence: 99%

An unusual case of pancreatic fistula

Johnston

Prew

Fraser

2013

Journal of Surgical Case Reports

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We report an unusual case of a pancreatic fistula communicating with an appendicectomy wound. This occurred following an episode of acute haemorrhagic pancreatitis. The patient was initially admitted with signs and symptoms indicating appendicitis and went to theatre for an open appendicectomy. However, this did not resolve his symptoms and a laparotomy was performed the next day revealing haemorrhagic pancreatitis. He endured a stormy post-operative course, the cause of which was found to be an external pancreatic fistula with discharge of amylase-rich fluid from the Lanz incision. A trial of conservative management failed despite multiple percutaneous drainage procedures and treatment with broad-spectrum antibiotics. After a second opinion was sought, it was decided to fit a roux loop anastomosis between the head of the pancreas and the duodenum to divert the fistulous fluid. This procedure was a success and the patient remains well 2 years later.

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Fistulojejunostomy for the management of refractory pancreatic fistula

Cited by 24 publications

References 27 publications

Routine use of U-tube drainage for necrotizing pancreatitis: A step toward less morbidity and resource utilization

Routine use of U-tube drainage for necrotizing pancreatitis: A step toward less morbidity and resource utilization

Diagnosis and management of postoperative pancreatic fistula

An unusual case of pancreatic fistula

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